Vaccine delivery to shift to regular programmes
Photo: iStock A worldwide initiative launched in April 2020 to ensure equitable access to COVID-19 vaccines is coming to an end. COVAX mechanism, which was launched to make the vaccines available equitably and, more importantly, to low-income countries that otherwise would not be able to afford them, is drawing to a close on December 31, 2023. The vaccine distribution will shift to regular immunisation programmes.
The facility was the brainchild of Gavi-the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), World Health Organization (WHO) and United Nations Children’s Fund (UNICEF).
COVAX is one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which was launched in April in response to the pandemic. This ACT Accelerator aimed to bring together governments, global health organisations, manufacturers, scientists, the private sector, civil society and philanthropy with the goal of providing innovative and equitable access to COVID-19 diagnostics, treatments, and vaccines. The COVAX pillar was focused on the latter.
Read more: Lateral thoughts: COVID-19 vaccines and a game of chance
Since the beginning of the pandemic, COVAX delivered nearly 2 billion doses of vaccines to 146 countries and averted an estimated 2.7 million deaths in Advance Market Commitment lower-income participating economies, WHO said in a statement announcing the end of COVAX. It helped lower-income countries achieve 57 per cent two-dose coverage, compared to the 67 per cent global average, it further claimed.
Gavi-the Vaccine Alliance will continue to provide COVID-19 vaccines and delivery support to low- and lower-middle-income countries in 2024 and 2025, with 58 countries requesting 83 million doses for 2024, the global health body clarified.
Meanwhile, COVAX is left with billions of unspent dollars, said a September 2023 report by medical journal The Lancet. “COVID-19 is no longer a public health emergency of international concern and country demand for COVID-19 vaccines has slowed greatly. As a result, Gavi, which raised resources for COVAX, might end up with more than $3 billion in unspent donor grants,” the report stated.
According to Gavi, $2.7 billion in grant money remains unspent, the report further said. A large portion of this—$1.9 billion—was money freed up in early 2022 after Gavi renegotiated contracts with vaccine manufacturers, reducing COVAX’s obligations to purchase 800 million doses in light of lower demand. In addition, income from donor grant investments could amount to nearly $500 million by 2025, according to Gavi documents, the report added.
The WHO release stated that the mechanism faced several challenges — it was initially limited in its ability to sign early contracts with manufacturers due to a lack of cash reserves. While COVAX was able to ship doses to 100 economies in the first six weeks of global roll-out, export bans and other factors delayed large-scale deliveries until the third quarter of 2021.
While COVAX’s efforts were necessary, it may not have been enough. A January 2023 report by Down To Earth pointed out that since the beginning of the pandemic, COVAX has delivered more than 1.8 billion doses to 146 countries, with more than 90 per cent of these doses going to people in lower-income countries, according to UNICEF data.
However, 13.2 billion doses have been administered globally and this 1.8 billion is a mere drop in comparison.
Read more: COVID-19 vaccines for all: Why COVAX is not working
13.53 billion doses of the COVID-19 vaccine have been administered globally through December 20, 2023, according to online data publication Our World in Data. While about 70 per cent of the world population has received at least one dose of the COVID-19 vaccine, just 32.9 per cent of people in low-income countries received at least one dose.
Burundi in east Africa received the least number of vaccinations, with 0.32 per cent of its population receiving at least one dose of a COVID-19 vaccine. Yemen (3.85 per cent), Haiti (5.73 per cent), Papua New Guinea (7.27 per cent), Madagascar (10.44 per cent) and the Republic of the Congo (13.93 per cent) were some of the other countries with the least number of vaccinations.
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